Tufts Health Plan EDI

Tufts Health Plan EDI mission – electronic solutions for healthcare needs Tufts Health Plan EDI commitment surves for providing clients with the easiest and most comfortable service. From member eligibility status and benefit information to claim submission and clinical information, your office can dramatically improve administrative costs with less paper and less time on the phone. Tufts Health Plan EDI tools Read More →

271 ASC X12

271 ASC X12 Premium Payment Grace Period Notification: public review of Implementation Guide (007030X344) 271 ASC X12 Premium Payment Grace Period Notification Implementation Guide (007030X344) was developed by Insurance Subcommittee of ASC X12. Now this guide is available for public view. During this period the committee will provide an informational forum where the audience can discuss the document, review comments and Read More →

clearing house

Healthcare Eligibility, Coverage and Benefit Request (270) and Response (271) additional notes concerning batch and timing Healthcare Eligibility, Coverage and Benefit Request (270) and Response (271) EDI transactions were already discussed earlier in the blog. You can find general information about these healthcare EDI transactions as well as the description of the relationship during the Read More →

270, 271 edi

270, 271 EDI relationship: senders and receivers, subscribers and dependents 270, 271 EDI transactions basic information was described in our previous blog post. Today we speak about the relationship between the participants of the 270, 271 EDI transactions process. During 270, 271 EDI exchange provider of service can request more detailed eligibility information other than a patient’s standard eligibility. Read More →

270/271 healthcare

270, 271 Healthcare Eligibility, Coverage and Benefit Inquiry (270) and Response (271) EDI Transaction Definition 270, 271 Healthcare transactions, their relationship, functions and purposes will be described further in the post. The 270 transaction is the EDI function that requests eligibility and benefit information from the Insurance Company of the patient. It is set to receive Read More →

834 hipaa edi

834 Healthcare EDI Transaction – Benefit Enrollment and Maintenance 834 Healthcare EDI Transaction (Benefit Enrollment and Maintenance) is used to provide enrollment information from sponsors to insurance companies. Sponsors are typically corporations or other institutions that provide health care benefits to their employees. The 834 Healthcare EDI can be used to provide initial enrollment and also Read More →

edi training chicago

EDI Training Chicago – EDI Fundamentals and Best Practices and HIPAA EDI Advanced Course EDI Training Chicago is a good possibility to widen your EDI knowledge and become an EDI professional in the field of HIPAA and healthcare EDI. Today many EDI specialists are self-taught or just get information about electronic data interchange from vendor sources (guidelines). This Read More →

HIPAA EDI Privacy

HIPAA EDI Privacy – part of the Anthem’s HIPAA regulations HIPAA EDI Privacy  addresses protecting the privacy of protected health information (PHI). As part of the HIPAA regulations, the government has established some controls. They will limit how, when and where protected health information is shared. Medical information, as well as emographic information, is “Protected Health Information” (PHI). Anthem Read More →

edi loop

Health industry EDI non-medical related code sets as an integral part of electronic transactions Health industry EDI code sets include any set of codes used for encoding data elements. Examples: tables of terms, medical concepts, medical diagnosis, or medical procedure codes. They are used in Health industry EDI to describe various health care services, procedures, tests, Read More →